| Objective To study the mechanism of required growth hormone resistance in patients with chronic congestive heart failure(CHF). Methods 95 patients with congestive heart failure were divided into three groups[ Ⅱ(n=28),Ⅲ(n=36) or Ⅳ(n=31)] according to New York Heart Association criterion . There were 30 healthy people as a control. Plasma Growth Hormone (GH) ,Insulin Growth Factor 1 (IGF-1) and Insulin Growth Factor Binding Protein 3 (IGFBP-3) concentrations were measured by radioimmunnoassay, and growth hormone sensitivity was assessed by log(IGF-1/GH). Results Plasma GH[(5.832±1.414μIU/ml)vs(1.562±0.968μIU/ml)] were higher in patients of group Ⅳ than those in normal subjects(P<0.001), but GH had no difference statistically among group Ⅱ,Ⅲ and control. Patients with congestive heart failure showed significantly lower plasma IGF-1, IGFBP-3 than those as a control. NO in patients of control, groupⅡ,groupⅢ and groupⅣ were respectively (9.518±1.237)μmol/l,(19.808±0.90)μmol/l,(35.857±8.42)μmol/l and(52.800±16.437)μmol/l (P<0.001)。Log(IGF-1/GH)[(0.953±0.565)vs(2.139±0.595)] was decreased significantly in group Ⅳ than those in normal subjects (P<0.001). Then log(IGF-1/GH) were negatively correlated with NO(r=-0.485, P<0.001), and positively correlated with IGFBP-3 (r=0.481, P<0.001) .Conclusions There was "Required Hormone Resistance" in patients with severely congestive heart failure. Excessively increased levels of NO weakened growth hormone sensitivity . The IGFBP-3 and NO might be the predictable indexes for the growth hormone sensitivity . |
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